Order Form
Name
Company
Address
City
 
State
Zip
Country
Email
Phone
Fax
Rx Software
Vendor
Vendor Phone
Vendor Fax
Can you lookup drug in computer software by entering NDC# ?    Yes    No    Not Sure
Computer Operating System?   
Computer Brand
Computer Type
Keyboard Brand
Terminal Brand/Model
Size of 1st keyboard computer cable plug?    *
Size of 2nd keyboard computer cable plug?    *
* Other types of keyboards or terminals may require special cables and/or power supply at an extra cost.

RxScan Kit
Service Contract 1 Year
($60/year for each scanner)
Shipping & Handling
 
Tax
 

Yes, I would like to receive relevant information from RxScan via e-mail in the future.
RxScan® - Designs for Quick Installation and Effortless Use
© 1998 - 2007. U.S. Patent Numbers 6,098,892 and 6,260,761 & patents pending.